Malignant Hypertension

(Hypertensive Emergency; Hypertensive Crisis; Hypertensive Urgency)

by
Alice A. McCarthy, MBA

Definition

Malignant hypertension is blood pressure that is so high that it is damaging to the body. The brain, heart, blood vessels, eyes, and kidneys are most at risk.

This is a serious condition that will need immediate care. Rapid care can stop long-term problems. If it is not treated, malignant hypertension can quickly cause severe damage. It can lead to problems such as
kidney failure
or vision loss.

Missing doses of medicine for high blood pressure, like beta-blockers or clonidine, which can cause a rebound effect

Risk Factors

Malignant hypertension is more common in:

Men

Smokers

People with high blood pressure 140/90 or higher

Symptoms

Malignant hypertension can cause:

Chest pain

Difficulty breathing

Headache

Visual problems

Nausea and vomiting

Numbness/weakness of the legs, arms, face

Malignant hypertension can lead to hypertensive encephalopathy which can also cause:

Mental changes like
anxiety

Confusion

Fatigue

Seizure

Diagnosis

Your doctor will ask about your symptoms and past health. A physical exam will be done. Blood pressure will be taken in both arms. It will be taken while you are lying down and while standing up. If the readings remain high the doctor will do the following:

Listen to the heart

Test nervous system

Examine eyes for swelling or bleeding in the eye

To look for any damage that may have occurred your doctor may also order:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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